Needle holder having a rotating clamp for surgical sutures



INVENTOR. ENRICO DORMIA A TTORNE YS.

Feb. 2, 1965 E. DORMIA NEEDLE HOLDER HAVING A ROTATING CLAMP FOR SURGICAL SUTURES Filed July 27, 1961 3 Sheets-Sheet 1 FIG. l

Feb. 2, 1965 E. DoRMlA 3,168,097

NEEDLE HOLDER HAVING A ROTATING CLAMP FOR SURGICAL SUTURES Filed July 27, 1961 5 Sheets-Sheet 2 FIG. 5b

INVENTOR.

ENRICO DORMIA ATTORNEYS.

Feb. 2, 1965 E. DORMIA 3,168,097

NEEDLE HOLDER HAVING A ROTA'I'ING CLAMP FOR SURGICAL SUTURES Filed July 27, 1961 3 Sheets-Sheet 5 FIG. T FIG. 9

J fi; 33 F|G.|OG

19% 34 20 Flmob 22 no l io INENTOR.

ENRICO DORMIA ATTORNEYS.

United States Patent Ciifice Patented Feb. 2 H365 3,lii,tl97 NEEDLE HLEER HAVNG A RTATING CLAMP FR SURGlCAL S'U'URES Enrico Dormia, Milan, Italy, assigner to Forges S.,A, Paris, France Filed lilly 27, 1961, Ser. No. 127,339

Claims priority, application Italy, Aug. 2, 196i),

13,851/60; .lilly l2, 196i, 12,742/61 8 Claims. (Cl. 12S- 340) This invention relates to the needle holders used for deep sutures in surgical operations.

Heretofore such sutures have had to be made using sleeve type suture needles such as stationary Reverdins needles or pivoting boomerang needles. The method of using these needles is as follows:

First, the tissues to be sutured are pierced until the needle point and the needle eye are clear. Second, catgut or horsehair is threaded through the needle eye. Third, the threaded needle is withdrawn, pulling the catgut after it. Fourth, the needle is removed and the two ends of the catgut are joined together.

This technique has a number of disadvantages. The second step of threading the catgut into the needle eye is often difhcult when it has to be performed at the bottom of a cavity (bladder) and. therefore at some distance from the operator conditions of poor visibility. Also, duringthe third step of withdrawing the needle there is a risk of damaging tissues, because the loop of catgut projects beyond the sides of the needle and tends to Widen the punctiforrn passage formed by the needle.

The needle holder of this invention obviates all these disadvantages and also enables eyeless needles to be usedi.e. suture needles where the catgut or horsehair is attached to the base and is therefore in extension of the needle.

The needle holder according to the invention comprises a rotatable clamp for securing the needle, means for rotating the clamp and means for moving the jaws of the clamp relatively to one another in order to grip and release the needle,

In a preferred embodiment of the needle holder according to the invention, it comprises an elongated tubular member and a clamp having jaws provided by a rod and a hollow member within which the rod is arranged to move axially. r"She clamp is fitted to one end of the tubular member and is rotatable about its axis which is perpendicular to the axis of the tubular member, whereby a needle held by the clamp can be rotated in a plane parallel to the axis of the tubular member. A handle is fitted to the other end of the tubular member and activates the movement of a rod or spindle arranged to move axially within the tubular member, the rod having areturn spring and being adapted to produce the relative movement of the clamp jaws. A sleeve which has a trigger-like handle, is mounted movablyvon the tubular member and operates, through the agency of transmission elements and against the actionof a return spring, the rotation of the clamp. The handle and the sleeve have relcasable, spring-loaded elements to form an end-oftravel stop.

The needle holder is operated as follows:

(l) The eyeless needle is first placed in the needle holder clamp, then engaged, by a rst rotary movement, in the tissues to be sutured until the needle point emerges out of the tissues.

(2) Second, the clamp is released and. releases the needle which stays held in the tissues.

(3) Third, the visible point of the needle is gripped in the clamp of the needle holder.

(4) Fourth, the needle is rotated a second time (continuing the first rotation) until it is withdrawn from the tissues and until it and the end of the catgut are completely clear.

(5) Finally, the needle holder clamp is released to release the needle, whereafter the two ends of the catgut are joined together.

Suturing is therefore performed by a continuous movement of the needle instead of by the baclt-and-forth movement ofthe prior art devices.

Other features and advantages of the needle holder according to the invention will become apparent from the following detailed description made with reference to the accompanying drawings illustrating, by way of example, embodiments of the invention. In the drawings:

FIGURE 1 is a side View of the needle holder;

FGURE 2 is a view in longitudinal section taken along the line ll-ll of FIGURE 1;

FIGURE 3 is a view in cross-section taken along the line lll-Ill of FIGURE l;

FGURE 4 is a detailed view showing a curved needle with its thread;

FIGURES 5a and 5b are views of details showing the needle clamped between the jaws in two opposed positions;

FGURES 6a and 6b show the needle clamped near its pointed enc, also in two opposed positions;

FIGURE 7 illustrates a diierent arrangement of the handle device;

FGURES 8 and 9 are views of details of the device for controlling and locking rotation of the clamp;

FGURES 10a and 10b illustrate different arrangements of the lever device for controlling rotation of the clamp; and

FIGURE 1l is a view of a detail or the clamp.

The needle holder illustrated in FIGURES l and 2 comprises a tubular member l, a clamp havin(y two jaws provided by co-operating faces of the cylindrical rod 2 and cylindrical hollow member 3, within which the rod L slides, the clamp being rotatable around its axis X-X perpendicular to the axis of the tubular member, and a handle formed with loops and comprising a stationary arm d and another arm S which is articulated at 6 and has a projection co-operating in its angular movement with a rod or spindle 8 slidable in the tubular member l. The rod ti is loaded by a return spring 9 and its end is provided with an inclined surface or wedge member 10 which co-operates with one of the ends of a rocker 1l pivotally mounted at 12, the other end of the rocker 11 acting upon the inner rod 2 of the clamp to move the rod Z against the action of a return spring 13 as the wedge member il) is moved within tubular member 1,

To the member 3 of the clamp is rigidly secured a small coaxial pulley 14 around which passes one turn of a ilexible cable 15, the ends thereof being secured to the ends of short rods 16, 17 respectively, one 1 7 of which is acted on by a return spring l while the other rod 16 is secured to a sleeve 19 comprising a trigger 20 and slidable on the member 1 between stops 21 and 22. The lever 2l) can be devised to be rotatable on the sleeve in order that the needle holder may be used equally satisfactorily either in the normal position or in the reverse position. To this end, the lever 2l) may be fitted to an outer auxiliary sleeve 33 (FIGURES 10a and 10b) which is rotatable around the main sleeve i9 and which is maintained longitudinally between stops. To ensure that the auxiliary sleeve S3 does not rotate too freely, its rotation is checked by a springd` mounted within a shoulder 35 acting as a base for the lever 2l?, the spring 34 bearing against the inner and main sleeve 19. Preferably at least one jaw of the clamp is knurled (FIGURE 1l), a step which gives an obvious advantage.

26, having passed the end, engages in the slot to lock,

the spring strip and the sleeve and oppose the action of the return spring.

Preferably, the base of the tubular member has a reinforced section on the side formed with the slot 27 so that the depth thereof can be relatively great, with the` result of improved guiding of the inger 25. FIGURE 8 is a view in cross-section of the base showing the reinforced part 4t) and the finger 25 received in its slot. Also, the finger 25 has at its end a bent part 31 (FlGURE 9) abutable by the end 32 of the sliding rod 8, so that the finger 25 can be released when the arms 4, 5 of the handle are moved apart from one another.

This needle holder operates as follows:

Starting from the open position illustrated in the drawings, the unsharpened end of a curved needle 29 having a thread 30 attached to it is introduced between the two jaws, whereafter, with the fingers in the loops of the two arms 4, 5, the needle is clamped between the two jaws 2, 3. A third finger is used to pull the trigger 20 to slide the sleeve 19 towards the handle until the click of the stop catch 26 beyond the slot 27 is heard. Meanwhile, movement of the handle 20 rotates the clamp which in turn rotates the needle through about 180. Thereafter, the handle with rings is opened to separate the jaws of the clamp from one another so that the needle is released; for the time being the needle is held by the tissues into which it has been introduced, while the spring strip 2S, which co-operates with an inclined projection 28 rigidly secured to the moving arm 5 of the handle, rises until the stop catch 26 disengages from the slot 27, whereafter the clamp rotates in the opposite direction land returns to its initial position. The point of the needle is then introduced into the clamp and the previous steps are repeated to give a further rotation of the needle through about 180 and therefore to pass the suture thread into the tissues.

The system for moving the jaws of the clamp apart from one another can, ifvrequired, take the form of two symmetrical arms, both of which can move and which are connected by connecting rods articulated to the clamp control rod. With this arrangement the instrument can be used equally satisfactorily either in the normal position or in the reverse position.

Such an arrangement is shown in FIGURE 7 where the base 22 is secured to one end of the tubular member 1 and is pierced with an aperture through which the sliding control rod 8 can pass freely. The arms 4, 5 of the two handles are articulated to the two ends of the base 22 respectively, while connecting rods 39 connect the arms 4, 5 to the end of the sliding control rod 8.

I claim:

1. A needle holder for use with Va needle effecting surgical sutures comprising an elongated tubular member,

clamp means adapted to hold said needle including a hollow member having a cut-out portion adjacent one end thereof and a rod slidable within said hollow member, the end of said rod facing the cut-out portion of said hollow member and the facing surface of said cut-out portion forming a pair of opposed clamping jaws, and spring means associated with said rod normally holding said clamping jaws apart in the open'position thereof, said hollow member being rotatably mounted at -one end of said tubular means for rotation about an axis passing through said clamping jaws and perpendicular to the axis of said tubular member,

means for selectively clamping said jaws together against the action of said spring means to hold said needle including spindle means axially slidable in said tubular member, a rocker arm on said tubular member engaging at the opposite ends thereof the end of said rod opposite said clamping jaws and said spindle means, said spindle means including a wedge member engaging said rocker Iarm for applying axial movement of said spindle means to said clamping jaws to close the same, a handle means adapted to be operated by one hand secured to the end of said tubular member opposite said clamp means including at least one pivotal arm for selectively axially moving said spindle means to close said clamping jaws and relcasable detent means for locking said pivotal arm in the position thereof corresponding to the clamping position of said clamping jaws, and first return spring means associated with the tubular member and said spindle means for normally holding said spindle means in the position thereof corresponding to said open position of said clamping jaws, and

means for selectively rotating said clamp means including pulley means secured to said clamp means, cablelike means passing around said pulley means, and an actuating sleeve means including a trigger member adapted to be operated by said hand, said actuating sleeve means being slidablymounted on said tubular member and operatively secured to one end of said cable-like means for pulling said cable-like means to rotate said pulley and therewith said clamp means, and second return spring means operatively secured to the other end of said cable-like means and said tubular member for normally keeping said clamp means in a preselected radial position with respect to said axis to effect return of said clamp means to said preselected position upon release of said actuating means.

2. A needle holder as defined in claim l, wherein said actuating sleeve includes further releasable detent means for holding the same in a position to which it has been moved in rotating the clamp means, said further releasable detent means comprising an inclined flat projection operatively secured to said Iarm for selectively axially moving said spindle means, a spring strip with an end of travel stop catch cooperating with said inclined flat projection so that toward the end of the opening movement of said clamping jaws, the spring strip is raised and releases the stop catch so that the sleeve can return to its normal preselected radial position, and wherein said 4actuating sleeve is additionally provided with an auxiliary sleeve adapted to rotate around the actuating sleeve and a trigger for operating the actuating sleeve secured to said auxiliary sleeve, and means for checking rotation of the auxiliary sleeve relative to the actuating sleeve whereby the needle holder may be used either in the normal position thereof or in the reverse position thereof.

3. A needle holder for use with a needle effecting surgical sutures comprising an elongated tubular member.

clamp means adapted to hold said needle including a pair of opposed clamping jaws at least one of which is movable relative to the other to provide a clamping force therebetween and spring means associated with said one clamping jaw normally holding said clamping jaws apart in the open position thereof, said clamp means being rotatably mounted at one end of said tubular means for rotation about an axis passing through said clamping jaws and perpendicular to the axis of said tubular member,

means for selectively clamping said jaws together against the action of said spring means to hold said needle including spindle means axially slidable in said tubular member, a rocker arm engaging at the opposite ends thereof said one clamping jaw and said spindle means, said spindle means including a wedge member engaging said rocker arm for applying axial movement of said spindle means to said clamping jaws to close the same, means for selectively axially moving said spindle means to close said clamping jaws, and first return spring means associated with the tubular member and said spindle means for normally holding said spindle means in the position thereof corresponding to said open position of said clamping jaws, and

means for selectively rotating said clamp means including pulley means secured to said clamp means, cable-like means passing around said pulley means, an actuating sleeve slidably mounted on said tubular member and operatively secured to one end of said cable-like means, and second return spring means operatively secured to the other end of said cablelike means and said tubular member for normally keeping said clamp means in a preselected radial position with respect to said axis to effect return of said clamp means to said preselected position upon release of said actuating means.

4. A needle holder as defined in claim 3, wherein said means for selectively axially moving said spindle means comprises a handle adapted to be operated by one hand secured to the end of said tubular member opposite said clamp means and including at least one arm pivotally secured to said tubular member and operatively connected to the spindle means for axially moving the same, said handle including releasable detent means for locking the pivotal arm in the position thereof corresponding to the closed position of said clamping jaws.

5. A needle holder as defined in claim 3, wherein said pair of opposed clamping jaws are, respectively, a hollow cylindrical member and a cylindrical rod axially slidable within said cylindrical member, the jaws of said clamp means being formed by one end of said rod and a facing surface in a cut-out end of the hollow cylindrical member, said one clamping jaw being formed by said cylindrical rod.

6. A needle holder as dened in claim 3, wherein said actuating sleeve includes releasable detent means for holding the same in a position to which it has been moved in rotating the clamp means, said releasable detent means comprising an inclined fiat projection operatively secured to said arm for selectively axially moving said spindle means, a spring strip with an end of travel stop catch cooperating with said inclined at projection so that toward the end of the opening movement of said clamping jaws, the spring strip is raised and releases the stop catch so that the sleeve can return to its normal preselected radial position.

7. A needle holder as defined in claim 3, wherein said actuating sleeve is provided with an auxiliary sleeve adapted to rotate around the actuating sleeve and a trigger for operating the actuating sleeve secured to said auxiliary sleeve, and spring means for checking rotation of the auxiliary sleeve relative to the actuating sleeve whereby the needle holder may be used either in the normal position thereof or in the reverse position thereof.

8. A needle holder for use with a needle effecting surgical sutures, comprising an elongated tubular membei,

clamp means for releasably holding said needle including opposed clamping jaws adapted to hold said needle and spring means normally holding said clamping jaws apart in the open position thereof, said clamp means being rotatably mounted at one end of said tubular member for rotation about an axis passing through said clamping jaws and perpendicular to the axis of said tubular member,

means for selectively clamping said jaws together against the action of said spring means to hold said needle including spindle means axially slidable in said tubular member, means operatively transferring axial movement of said spindle means into a movement for clamping one of said jaws against the other, means for selectively axially moving said spindle means, and return spring means for normally holding said spindle means in the position thereof corresponding to said open position of said clamping jaws, and

means for selectively rotating said clamp means including an actuating sleeve slidably mounted on said tubular member and means for normally keeping said clamp means in a preselected radial position with respect to said axis of rotation to effect return of said clamp means to said preselected position upon release of said actuating means.

Reerences Cited by the Examiner UNITED STATES PATENTS 1,449,087 3/23 Bugbee 12S- 340 2,348,218 5/44 Karle 128-340 2,370,545 2/ 45 Karle 12S-340 2,496,611 2/50 Warkentin 81-5.1 2,737,954 3/56 Knapp 12S-340 2,959,172 11/60 Held 12S-340 RICHARD A. GAUDET, Primary Examiner. RICHARD J. HOFFMAN, Examiner. 

1. A NEEDLE HOLDER FOR USE WITH A NEEDLE EFFECTING SURGICAL SUTURES COMPRISING AN ELONGATED TUBULAR MEMBER, CLAMP MEANS ADAPTED TO HOLD SAID NEEDLE INCLUDING A HOLLOW MEMBER HAVING A CUT-OUT PORTION ADJACENT ONE END THEREOF AND A ROD SLIDABLE WITHIN SAID HOLLOW MEMBER, THE END OF SAID ROD FACING THE CUT-OUT PORTION OF THE HOLLOW MEMBER AND THE FACING SURFACE OF SAID CUT-OUT PORTION FORMING A PAIR OF OPPOSED CLAMPING JAWS, AND SPRING MEANS ASSOCIATED WITH SAID ROD NORMALLY HOLDING SAID CLAMPING JAWS APART IN THE OPEN POSITION THEREOF, SAID HOLLOW MEMBER BEING ROTATABLY MOUNTED AT ONE END OF SAID TUBULAR MEANS ROTATION ABOVE AN AXIS PASSING THROUGH SAID CLAMPING JAWS AND PERPENDICULAR TO THE AXIS OF SAID TUBULAR MEMBER, MEANS FOR SELECTIVELY CLAMPING SAID JAWS TOGETHER AGAINST THE ACTION OF SAID SPRING MEANS TO HOLD SAID NEEDLE INCLUDING SPINDLE MEANS AXIALLY SLIDABLE IN SAID TUBULAR MEMBER, A ROCKER ARM ON SAID TUBULAR MEMBER ENGAGING AT THE OPPOSITE ENDS THEREOF THE END OF SAID ROD OPPOSITE SAID CLAMPING JAWS AND SAID SPINDLE MEANS, SAID SPINDLE MEANS INCLUDING A WEDGE MEMBER ENGAGING SAID ROCKER ARM FOR APPLYING AXIAL MOVEMENT OF SAID SPINDLE MEANS TO SAID CLAMPING JAWS TO CLOSE THE SAME, A HANDLE MEANS ADAPTED TO BE OPERATED BY ONE HAND SECURED TO THE END OF SAID TUBULAR MEMBER OPPOSITE SAID CLAMP MEANS INCLUDING AT LEAST ONE PIVOTAL ARM FOR SELECTIVELY AXIALLY MOVING SAID SPINDLE MEANS TO CLOSE SAID CLAMPING JAWS AND RELEASABLE DETENT MEANS FOR LOCKING SAID PIVOTAL ARM IN THE POSITION THEREOF CORRESPONGING TO THE CLAMPING POSITION OF SAID CLAMPING JAWS, AND FIRST RETURN SPRING MEANS ASSOCIATED WITH THE TUBULAR MEMBER AND SAID SPINDLE MEANS FOR NORMALLY HOLDING SAID SPINDLE MEANS IN THE POSITION THEREOF CORRESPONDING TO SAID OPEN POSITION OF SAID CLAMPING JAWS, AND MEANS FOR SELECTIVELY ROTATING SAID CLAMPING MEANS INCLUDING PULLEY MEANS SECURED TO SAID CLAMP MEANS, CABLELIKE MEANS PASSING AROUND SAID PULLEY MEANS, AND AN ACTUATING SLEEVE MEANS INCLUDING A TRIGGER MEMBER ADAPTED TO BE OPERATED BY SAID HAND, SAID ACTUATING SLEEVE MEANS BEING SLIDABLY MOUNTED ON SAID TUBULAR MEMBER AND OPERATIVELY SECURED TO ONE END OF SAID CABLE-LIKE MEANS FOR PULLING SAID CABLE-LIKE MEANS TO ROTATE SAID PULLEY AND THEREWITH SAID CLAMP MEANS, AND SECOND RETURN SPRING MEAND OPERATIVELY SECURED TO THE OTHER END OF SAID CABLE-LIKE MEANS AND SAID TUBULAR MEMBER FOR NORMALLY KEEPING SAID CLAMP MEANS IN A PRESELECTED RADIAL POSITION WITH RESPECT TO SAID AXIS TO EFFECT RETURN OF SAID CLAMP MEANS TO SAID PRESELECTED POSITION UPON RELEASE OF SAID ACTUATING MEANS. 